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Officers from the New York Police Department (NYPD) were deployed following the September 11 attacks and were exposed for prolonged periods to pollutant mixtures resulting from the collapse of the World Trade Center (WTC). The Living Heart Foundation conducted cardiopulmonary health screening for NYPD officers between September 28 and October 11, 2001 in lower Manhattan. Exposure information was collected simultaneously with the health survey using a questionnaire that identified the site of deployment, and the presence of smoke, odors and fumes. The objectives of this analysis were to conduct a pilot study of pulmonary health effects in NYPD officers exposed to the September 11 attacks. We randomly selected 446 NYPD officers for study from approximately 1,500 officers who were screened. We developed three exposure levels for the study subjects based on the questionnaire-derived exposure information. The definitions of these exposure levels are: lightly exposed level = officers not working at Ground Zero (GZ) or working at GZ with little exposure; moderately exposed level = officers working at GZ but not in the massive cloud of the collapse; and heavily exposed level = officers working at GZ in the massive cloud of the collapse. We observed positive relationships of exposure to the September 11 attacks with prevalence rates of cough (OR = 2.72, 95% CI = 1.40-5.28 for heavily exposed level; OR = 2.31, 95% CI = 1.19-4.47 for moderately exposed level), short of breath (OR = 2.44, 95% CI = 0.98-6.08 for heavily exposed level; OR = 1.78, 95% CI = 0.71-4.48 for moderately exposed level), and sputum (OR = 2.91, 95% CI = 0.99-8.57 for heavily exposed level; OR = 2.66, 95% CI = 0.90-7.88 for moderately exposed level). We did not observe other outcomes that were associated with an exposure-response pattern: Table. No caption available. To our knowledge, this is the earliest systematic health survey data obtained following the WTC attack, and has the unique attribute of simultaneously collected exposure data and cardiopulmonary data. These results suggest that associations may exist between the NYPD officers' cardiopulmonary health outcomes and the exposure to air pollution mixtures from the WTC collapse on 9/11. Further studies are needed to explore exposure-response relationships by including all 1,500 NYPD officers and controlling for major potential confounders. We are grateful to brave NYPD officers who were the Heroes working to find survivors and providing other services to victims of 9/11 disaster at the WTC. We are also grateful to over 200 volunteers who were the Angels conducting this health screening program for our heroes between two and four weeks after 9/11. Special thanks to Dr. Arthur Roberts who assembled the volunteer team within two weeks of 9/11. We also appreciate support from many anonymous contributors.